on twitter, facebook, instagram, google+ and more. ♪ new threats arrive, and force us to take new ideas on board about risk and vulnerability. you may have long since stopped worrying about ebola, are you ready for zika. the infection is spreading quickly throughout latin america, and has u.s. officials waiting for the cases bound to arrive in bloodstreams or in the next mosquito that lands on your arm next summer. a virus on the move.

it's the inside story. ♪ welcome to "inside story." i'm ray suarez. diseases move. they have always moved. what is different in the 21st century is how quickly it happens, and how viruses outsmarted our best efforts to contain them. the latest is zika, an illness first mound in -- found in the mountains of east africa. who is infected? who gets sick in are mosquitos the only vector or just the main one. and here in the united states, can we stop a disease that so far as mainly arrived here in the bloodstreams of infected travelers from becoming one that is swimming in the guts of american mosquitos. robert ray begins our program.

>> reporter: the colorful smallvillage in this puerto rico has a problem and the major is on edge. >> i'm very concerned because this is big problem that effected many of our families. >> reporter: of the approximately 20 cases of the zika virus in puerto rico one third are here. every evening the health department sprays the streets, hoping to kill the mosquitos that kill the virus. >> fumigation works on the adult population, but it does not take care of larvae or of the eggs. but it does give, unfortunately, the community a sense of security in the sense that then they don't do what they need to do. >> reporter: while health officials monitor standing water and sanitation in the neighborhoods, searching breeding spots, they cannot catch them all. this is someone's pool here in puerto rico in one of the

hardest hit areas. you can see it is not very well maintained. this is what scientists are so concerned about. what you are seeing on top of this water is mosquito larvae. you scoop this up, and there is the breeding grown for these mosquitos that cause the zika virus. in puerto rico's capitol of san juan, doctors are alerting pregnant patients, because of the potential correlation between the zika virus, and microcephaly a rare condition in which children are born with unusually small or deformed heads. >> i never encounter anything like this. the closest that i can recall something like this, i have to go back to 1980, and i wasn't even in medical school by that time, when hiv came out, and we had a lot of fear out of something that we knew very, very few amount of information. so i compare that to the level.

>> reporter: this doctor says the confusion, misinformation, and lack of communication from health officials to blame for some of the panic. for christina gonzalez who is due next month, the lack of information has been troubling. >> more information and information about prevention, because we're all -- we know that the mosquito is in puerto rico since -- forever, and we know about dengay, with but this is another story, because we know it could effect the baby. >> reporter: there have been no reports of women contracting the zika virus in puerto rico, but officials are just beginning to wrap up their warnings here as the world health organization says there could be up to 4 million cases of the virus in the americas by the end of 2016.

robert ray, al jazeera. so much crash science has to be done to understand a virus on the move. has zika rount far ahead of our attempts to understand it? an onshore american transmission of the disease has been reported in texas from someone returning from latin america to a partner who has not traveled outside of the country. the spike of cases of microcephaly in brazil has caused panic in countries. large numbers of babies compromised from birth, beyond the individual family tragedy, that's just about the last thing those countries need. we'll explain what you need to know about a virus on the move this time on "inside story." i want to welcome back two men who have helped us understand new disease threats before. lawrence is the director of the

o'neal institute at georgetown university, and this doctor, assistant of medicine. doctor, let me start with you. what do we need to know about this virus? is it one of a family of similar viruss that we do know more about? >> it is. zika is part of a well-known family of viruses that include west nile fever and others that people are probably very familiar with. however, this virus was really a travel medicine oddity, and we're only learning a lot about it because of this major outbreak. it used to be considered a mild disease, but we're learning that may not be the full story. >> so can diseases like that change either in their home, in this case in uganda, we're told,

or mutate as it travels arrange the world? >> all viruses mutate, and it will be important to look at the sequence of this virus once we get a lot of samples to see if it has made any changes, but there is no indication it has done that so far, but it will be an important point to determine for our response efforts. >> professor, when any new disease is on our radar screen, how do you calibrate a proper level of concern about risks, versus counter measures? what are the metrics? what are the tools of the trade? >> well, that's a very good question, because very often we -- we panic and we should don't that. i mean certainly in the united states and other high-income countries, we have -- we're not going to be fully protected. it will come here as you said, ray, there's no question about that. it will come with mosquitos and

it will come from returning travelers, and particularly we're worried about the summer months when in -- in florida the gulf coast and a lot of people coming back from the rio olympics. but we have got air conditioning. we have got aggressive mosquito control, so it's not going to be a spin away epidemic here. but globally, and of course, in the united states, we really have to take this very seriously. mostly because of the -- the -- the very strong possibility, which is not yet definitively determined, that there is a connection to microcephaly among newborns, these are really severe birth defects, and neurological diseases, and so to me, it's got

a major public health dimension because of these babies, but it also has a critical moral and ethical dimension, because if we see nine months from this epidemic, a wave of microcephaly among young, very, very poor women, it will be unconscionable. so we need to be prepared. it's better to be overprepared than not prepared enough. >> i'm glad you brought up the moral dimension, because el salvador, and other countries have followed to basically counsel young women not to get pregnant until 2018. is that prudent or an overreaction? >> that's an overreaction, and it's more of an overreaction than we might think. because in latin america most countries -- not many, but most countries have severe

restrictions, even criminal penalties on birth control, contraception, and early-term abortion, so basically you are telling women not to get pregnant in the case of el salvador until the year 2017, and you are making it illegal for her to take any preventative steps to prevent being pregnant. i mean that's -- that's a violation of women's reproductive and human rights, and it's really, i think counterproductive from the point of view of public health. no, i don't like that. and i think w.h.o. should have weighed in against it. it didn't because of the politics of it, but -- but i'm willing to speak out loud and clear against that. >> doctor, we see pictures both of microcephaly infraantinfants%

of the cases don't get sick. >> right. this is one of the mysteries of zika. like you said 80% of people infected have no symptoms at all. and others have limited illness and it goes away. however, what we're finding is this association, and it really needed to be determined scientifically with proper studies to make sure this is a real signal, but microcephaly in women who are infected when they are pregnant and pass the virus on to the fetus. it's not clear that it's in every case of microcephaly, and there is a lot of literature that is starting to come out talking about the numbers here, and if this is an awareness bias, that people are on the lookout for microcephaly, and it is not truly the zika virus driving that. were it not for the microcephaly, i think people would still think of zika the

same way. >> told that thought. because i want to continue that on the other side of the break. zika, a virus on the move. stay with us. it's "inside story." >> even though we're in here, we're still human. >> how harsh conditions affect people on both sides of the bars. >> why did scott take his own life? >> the jail. >> some people might be scared to speak out but i'm not. i'm telling the truth.

♪ you are watching "inside story." i'm ray suarez. zika is a virus on the move. the world health organization

has declared the mosquito-born illness a global health emergency. there have already been an estimated 1.5 million cases in the hemisphere. some 3700 each in honduras and venezuela. many infected have only experienced minor systems, but far more frightening are the babies being born with microcephaly. my guests are still with me, and doctor, before the break, we were talking about how that link with microcephaly has not been nailed down. similarly the transmission through sexual contact in the texas has not been confirmed. how important is it to nail those variables down?

>> sexual transmission is less important. we had a case reported in 2008 in colorado. but this microcephaly link is novel avenue, and driving the public health response among citizens, so this is very, very important. a lot of these actions are premised on the fact that this is microcephaly. so we need to make sure we get this right, that there are not other factors involved. and you might see zika get transformed into a disease like rubella or german measles, which can be devastating to fetuses. >> professor, earlier in the program, you mentioned the olympics. tonight dilma rousseff, the president of brazil is talking to her people about the coming rio olympics. some people have even suggested they be postponed or canceled. is that a prudent response to

what we're facing right now? >> no -- no, it isn't. and i have been in discussion with authorities in brazil, and i think they have no intention of postponing or canceling the olympics, and i don't think it's necessary. but i think this could really impact the olympics, and i think the olympics can be a real amplifying effect for spreading zika virus to other parts of the world, every part of the world. but what we need to do -- what the brazilian authorities need to do, and what the united states cdc and the world health organization needs to help them with is a very aggressive mosquito-control program, particularly running up to the olympics. now it will be dry winter season in brazil at that time, so there will be reduced mosquito

activetive, but they will still be there. what is the worry is if there are zika infected mosquitos, and there are bound to be some, that will bite tourists, visitors, who will then go back to the northern summer where mosquitos are active. so it's not going to be postponed, but we need to be very aggressive at mosquito control. and also with public education. when people go down to rio, they need to know to wear long clothes, to spray themselves with -- with -- with insecticide, and stay in air conditioned locations. because these are very aggressive daytime biters, so we're going to have to be really careful. >> i want to talk more about the mosquitos later in the program. doctor we -- after just a very few years talked about west nile virus in the united states as being established in the

united states. what would it take to have zika established in the united states? something that every summer you have to worry about? >> zika is a little bit different than west nile. west nile has special characteristics that allowed it to be established in the united states so quickly. one is that west nile is spread by mosquitos that are very common. whereas zika is spread by mosquitos who are really in the southern part of the united states. and west nile has the ability to infect birds, which allowed it to traverse the united states very, very quickly. zika virus doesn't have that capacity. so the worst case scenario is we get zika transferred in florida, for example, the texas, mexico border, with dengay thrives.

i don't see it thriving in places where the mosquito doesn't live. >> could ongoing climate change change what you just said as a prediction in >> the temperature -- temperature has a weird variation with mosquitos. sometimes it increases their rank, but also decreases their flight range and decreases their life range. so it's hard to make a one for one with temperature rises and diseases like this. >> the world has long been stocked by debilitated and deadly diseases spread by mosquitos. so why don't we pay more attention to the mosquitos. zika, a virus on the move. stay with us. it's "inside story."

♪ >> welcome back to "inside story." i'm ray suarez. if you have seen any of the most recent coverage of the spread of zika, you will have seen those workers in protective gear, spraying insecticides, trying to tamp down zika by tamping down the mosquito.

add in chicken gunya, denge, and the worldwide killer, malaria, and those workers have a lot to answer for. keep water from pooling up. try to break the life cycle of the biting insects. has enough attention been paid to getting rid of, rather than merely suppressing mosquito. my guests are still with me. and professor, i guess there are all kinds of international legal, ethical, and on and on ramifications to setting out a goal to eliminate an animal from the world's biology. >> yeah, i mean, i don't think that currently is the goal, but the goal certainly is to drastically reduce the population. but it's controversial. there's certain controversial

methods. certainly spraying with ddt, all of your viewers will recall the controversy around that, because of potential harms to human health. there is also genetically modified mosquito that we now have the capacity to release into the environment, and that their offspring will die, which really reduces the population by about 90%. but that's also controversial, because any time you modify something in the ecology through genetic means there are controversies around it. but a lot of the way we think of these ethical controversies in the north are from a really very privileged point of view, because we're not the ones suffering. but if you were in the global south, and you were really seeing people sick and die from

malaria, yellow fever, denge, chicken gunya and a whole range of other maladies, you would want to aggressively reduce that population. and i was pleased to see that the world health organization when it declared a global health emergency, did call for a very aggressive mosquito control. for me, i would create a war on mosquitos. ray, i think the question that you asked before the break, you know, should we really be focusing on the mosquito vector? is the classic way to do public health, and i would really support that, because you get dividends, not just zika, but all of these other mosquito-born illnesseses. >> doctor every animal exists in a web of relationships, and as appealing as it is to think about a world without mosquitos, i was traveling in tanzania, and

talk to villagers who just assume malaria, and the suffering and death that comes from it, is a part of their lives. what would be involved in setting a course, setting a goal towards killing mosquito wherever we find them? >> i think that's a very good goal, and i would be all for it. because my standard is human life is the standard. and these mosquitos with the diseases, the list goes on and on and on, have plagued the human species basically since inception. what i think this would involve is an all-out war the way this malaria ratification went in the 1980s. and i do think we'll see dividends. if you look at the history of the campaign before it was abruptly stopped, you saw places

like sri lanka reverse the devastation that was had on their populations. and even in the u.s. it has long since passed time that we really went after the mosquitos. >> but i wonder in the past when we have done these kinds of things, the old saying, you can't fool mother nature, there is always this law of unintended consequences that comes to bite you in a different way. go ahead, doctor. >> well, i think we have -- we agree that we really should be very aggressive about mosquito control. i think you would -- really reap great dividends, and yes, there are always ecological concerns, and birds and fish and frogs feed off of mosquitos, and it is part of the eco logic chain, but when we have introduced the

genetically modified mosquitos, for example, and sprayed with ddt, and things, we haven't eliminated the mosquito population, but we reduced it enough, and we found no ecological effects, and great human effects. and what i wanted to mention -- >> quickly, please. >> okay. if you think about the fact that the united states and philadelphia and places like that, could stop this, why don't we? why musn't we do this in poor countries in the world. >> that's the challenge to the world. i want to thank my guests. >> yeah. >> an infection disease specialists, and assistant professor, and lawrence, of the o'neal institute for national and global health law at gorge continue to university. that's all for this edition. next time on "inside story." does america pander to its veterans. have we replaced taking care of them with cheaper and easier

praise. i'm ray suarez. have a great night. ♪ >> this is aljazeera america. live from new york city, i'm tony harris. a call for unity. president obama condemns anti-muslim rhetoric on his visit to an american mosque. and the epa said that it's the state's fault. and the ocean is filling with